15,477 research outputs found
DPVis: Visual Analytics with Hidden Markov Models for Disease Progression Pathways
Clinical researchers use disease progression models to understand patient
status and characterize progression patterns from longitudinal health records.
One approach for disease progression modeling is to describe patient status
using a small number of states that represent distinctive distributions over a
set of observed measures. Hidden Markov models (HMMs) and its variants are a
class of models that both discover these states and make inferences of health
states for patients. Despite the advantages of using the algorithms for
discovering interesting patterns, it still remains challenging for medical
experts to interpret model outputs, understand complex modeling parameters, and
clinically make sense of the patterns. To tackle these problems, we conducted a
design study with clinical scientists, statisticians, and visualization
experts, with the goal to investigate disease progression pathways of chronic
diseases, namely type 1 diabetes (T1D), Huntington's disease, Parkinson's
disease, and chronic obstructive pulmonary disease (COPD). As a result, we
introduce DPVis which seamlessly integrates model parameters and outcomes of
HMMs into interpretable and interactive visualizations. In this study, we
demonstrate that DPVis is successful in evaluating disease progression models,
visually summarizing disease states, interactively exploring disease
progression patterns, and building, analyzing, and comparing clinically
relevant patient subgroups.Comment: to appear at IEEE Transactions on Visualization and Computer Graphic
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Tracing diagnosis trajectories over millions of patients reveal an unexpected risk in schizophrenia.
The identification of novel disease associations using big-data for patient care has had limited success. In this study, we created a longitudinal disease network of traced readmissions (disease trajectories), merging data from over 10.4 million inpatients through the Healthcare Cost and Utilization Project, which allowed the representation of disease progression mapping over 300 diseases. From these disease trajectories, we discovered an interesting association between schizophrenia and rhabdomyolysis, a rare muscle disease (incidence < 1E-04) (relative risk, 2.21 [1.80-2.71, confidence interval = 0.95], P-value 9.54E-15). We validated this association by using independent electronic medical records from over 830,000 patients at the University of California, San Francisco (UCSF) medical center. A case review of 29 rhabdomyolysis incidents in schizophrenia patients at UCSF demonstrated that 62% are idiopathic, without the use of any drug known to lead to this adverse event, suggesting a warning to physicians to watch for this unexpected risk of schizophrenia. Large-scale analysis of disease trajectories can help physicians understand potential sequential events in their patients
Deepr: A Convolutional Net for Medical Records
Feature engineering remains a major bottleneck when creating predictive
systems from electronic medical records. At present, an important missing
element is detecting predictive regular clinical motifs from irregular episodic
records. We present Deepr (short for Deep record), a new end-to-end deep
learning system that learns to extract features from medical records and
predicts future risk automatically. Deepr transforms a record into a sequence
of discrete elements separated by coded time gaps and hospital transfers. On
top of the sequence is a convolutional neural net that detects and combines
predictive local clinical motifs to stratify the risk. Deepr permits
transparent inspection and visualization of its inner working. We validate
Deepr on hospital data to predict unplanned readmission after discharge. Deepr
achieves superior accuracy compared to traditional techniques, detects
meaningful clinical motifs, and uncovers the underlying structure of the
disease and intervention space
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